These are some of the key findings of the South African Health Review, an annual analysis of health trends compiled by Health Systems Trust, that was launched in Johannesburg last night (30 Nov).

This year’€™s SAHR focuses on maternal, women’€™s and children’€™s health, and it found ‘€œa steady increase in infant and under-five mortality and less than optimal maternal health status’€.

While few statistics about mental health exist, a study in the Western Cape estimated that a quarter of adults suffered from an episode of mental illness every year.

Depression, followed by anxiety disorders and post-traumatic stress were the most common conditions, according to a national study.

Women tended to suffer from depression and anxiety, with high rates of poverty, gender-based violence and HIV infection all being major contributory causes.

Men were more likely to suffer from alcohol-induced psychosis.

There is also a very high level of post-natal depression. Research in Khayelitsha in Cape Town found over a third of women were depressed two months after giving birth.

‘€œWomen’€™s social status and the effects of violence against women and children results in a variety of disabling mental conditions which have implications for the health system and society as a whole,’€ said HST CEO Dr Lilian Dudley.

The effect of HIV on women and children is a recurrent theme in the Review.

Over a third of children under five countrywide die of AIDS-related illnesses, but this figure jumps to 50% in KwaZulu-Natal, the province with the highest HIV rate.

More than double the number of children under five die in KwaZulu-Natal, Mpumalanga and the Free State (provinces with high HIV rates) than in the Western Cape.

The under-five mortality rate was 58 deaths per 1000 births in 2003 but had increased to 72 deaths per 1000 by 2005.

In addition, about one-fifth of children suffer from chronic conditions such as heart disease and neurological conditions.

By 2000, HIV was responsible for 55% of deaths of women aged 15 to 54, 10 times more than their next biggest killer, which is tuberculosis.

Despite the fact that nine out of ten women giving birth now do so under the guidance of health workers, women dying in or soon after childbirth almost doubled between 1998 and 2003, with 1 154 women dying in 2003 in comparison to 676 in 1998.

The major reason for the increase is that many of the pregnant women are weakened by HIV-related infections.

Researchers Debbie Bradshaw and Nadine Nannan thus call for antiretroviral drugs to be available in primary healthcare clinics where most births take place. ‘€“ Health-e News Service.

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·               By the age of 18, over one-fifth of girls have given birth at least once.

·               Limpopo has the highest teen pregnancy rate.

·               This year, there are only 405 psychologists and 715 dentists working in public health.

·               The North West has the fewest doctors (11,5 per 100 000 people), pharmacists (2.1 per 100 000) and professional nurses (88.9 per 100 000) in the country.

·               The Northern Cape has the highest vacancy rate for doctors (53%)

·               KwaZulu-Natal has the highest vacancy rate for professional nurses (42.5%)

·               Nurses in the Northern Cape have the biggest workload, seeing an average of 50 patients every day. Nurses in the North West and KwaZulu-Natal are also very busy.